Caregivers Need to Know … and Record

If you are a loved one or other caregiver of a senior, there are some very important pieces of information that you should have at your fingertips (not literally, but readily available when needed).  All too often, we don’t have this information and we have not thought about gathering it.

Let’s all do it together, the time is now!

Too many people who don’t do it in advance find that at the time it is needed things are just too stressful and rushed to gather and record the information.

In a notebook, jot down this information for the senior loved ones in your life.

  • Full name including middle and maiden names
  • Home address and phone number
  • Social security number
  • Medicare/Medicaid number
  • Doctor’s name and contact information
  • Full list of medications and dosages including prescription and over-the-counter medications as well as supplements/herbals
  • List of allergies
  • List of medical diagnosis and dates of last hospitalization
  • Blood type (if available)
  • List of medical devices used, names, manufacturer and any other pertinent details
  • Where the advance directives copies are stored (if you don’t know, find out and secure a copy; if there are none, try to get  them executed or discuss your senior’s wishes and write down their thoughts here)
  • Other contact numbers of importance such as lawyer, accountant, church leader, financial planner
  • Banking information: account numbers, safety deposit box and key, passwords, PIN
  • Insurance company. policy numbers and contact person and phone number
  • Pre-planned funeral information and contact number (if applicable)
  • Utility companies: list and contact information
  • Poison Control Phone Number

It might take you a little time to get all this information together but once you have it all in one place, you will always be ready for a situation that makes the information necessary!

Keep this notebook handy and safe.  You might want to keep another copy somewhere else or with other family members so everyone is ready in an emergency!  Keep in mind, though, that some of the information is private and could be used for identity theft or other purpose harmful to your loved one!

Have we missed a piece of information that you keep for your loved ones or you feel should be on our list?  Your suggestions are appreciated.

DNR & Other Advance Directives: What Families & Caregivers Need to Know (Part 2)

You responded so positively to our post, Part 1: DNR & Other Advance Directives, asking for more information, that we knew we had to post Part 2 right away.

We know we can’t hope to provide the information everyone needs to answer your individual questions, so we hope to give you enough information to know what questions you need to ask and to determine which documents to consider further.

In Part 1 we listed the Advance Directives to introduce you to them.  Let’s look at each different document so that you will understand them better.

1. Do Not Resuscitate

Do Not Resuscitate is a directive in the form of an order to healthcare personnel, such as physicians, emergency medical personnel, nurses and others, who may need to save your loved one’s life if his heart should stop beating or he stops breathing.  This document can be written with your loved one and your family before it is needed and also with your senior’s physician during a hospital stay.  A DNR order involves refusing to allow someone to perform CPR with chest compressions and ventilation support in the event your senior stops breathing or has heart failure.

This is a traumatic process for your loved one and when dealing with an elderly person it can be dangerous.  The outcome may include having to receive life support after resuscitation is given using mechanical ventilation known as a breathing tube.  This life support could be needed for a short time or longer, depending on the situation. Caregivers who don’t have clear guidelines from their senior loved one should ask themselves “is that what my father would want”?  Fractured bones can also occur when a senior receives CPR, especially if he has fragile bones.  If the wish for or against a DNR is clear among the family members before an emergency occurs, it will make it easier and faster when the time comes to inform those who need to know, especially emergency personnel, so that the correct and desired action is taken.

2. Living Will

A living will is a document that spells out what medical treatment is desired by your senior loved one; it can cover a variety of specific wishes such as your senior’s desire to not be kept alive in a terminal condition if there is little hope for recovery; your senior loved ones desire to not want to be kept alive by artificial means such as a breathing machine or the desire to discontinue any life sustaining treatment when there is no hope for recovery. Your senior loved one can also decide if he wants a feeding tube placed which could keep him alive regardless of the prognosis for recovery. Some feeding tubes are needed temporarily, others are need lifelong. This document can help the caregiver or surrogate make decisions that were dictated directly by the senior and help the caregiver feel that they upheld their senior’s wishes. A living will can be overridden by the family at the time of the emergency if all parties are in agreement; however, this likely will go against the stated wishes of the senior.  The desire for or against organ donation can also be documented in the living will.

3. Healthcare Proxy

A healthcare proxy gives a specific, stated caregiver the power to make decisions for the senior in the case of emergency when the senior is unable to speak for him or herself. The healthcare proxy has the authority to make decisions for the senior that he feels the senior would make for himself if he was able. It is helpful for this caregiver to have a living will, DNR or a clear knowledge of what the senior would want when executing a power of attorney for healthcare decisions. If no clear path has been determined prior to an emergency, it will be up to the caregiver to make a decision that all family members can agree upon. Unfortunately, this decision often needs to happen within minutes when tragedy strikes and often results in disagreement in the family when all parties aren’t involved. The more communication occurring before a tragic event, the better

4. Durable Power of Attorney

A durable power of attorney usually allows a designated caregiver to make both healthcare and financial decisions for a senior loved one such as completing banking, applying for Medicaid, cashing Social Security checks, selling property or assets, paying bills and other legal transactions while the senior is incapacitated as well as the healthcare decisions needed in the event of an emergency. This caregiver needs to know not only what the healthcare treatment desires are, but also where to find paperwork and records necessary to carry out their personal duties.

Next Steps

Knowing the documents and what needs to be done are only the first steps.  The big steps can be tough but are the keys:

  • learn the wishes of your senior loved ones;
  • put them in writing;
  • keep all advance directives in a place where all caregivers and family members have access in an emergency; and,
  • give a copy to the primary doctor so he or she will be ready as needed and bring a copy when you have a scheduled hospital procedure.

We hope this helps you prepare in advance for some of the most difficult times to make them less difficult for your senior loved one, your family and you.

DNR & Other Advance Directives: What Families & Caregivers Need to Know (Part 1)

Many caregivers and other family members are currently struggling with health decisions for their senior loved ones.  If you aren’t yet, it’s likely you will eventually be asked to make these decisions and, actually, the sooner the better for everyone involved.  These documents need to be completed before they are needed when all parties are competent enough to fully understand and make instructions for their medical treatment.

If your loved one is able, you should talk with her about what she wants to happen when a medical emergency arises.  The entire family should talk about this together so everyone hears the same story and will act in unison when the time comes.

There are several advance directives that everyone should execute whether they are young or old.  Talking about it doesn’t mean you will make the need for it happen sooner. As a caregiver of a senior, helping them execute these documents will make your burden lighter.  Being able to openly discuss wishes for healthcare with the entire family will allow everyone to focus their attention on the emergency at hand instead of spending your energies trying to make a quick and uninformed decision – one that you may regret later.

Types of Advance Directives

  1. Do Not Resuscitate  — a directive in the form of an order to healthcare personnel, such as physicians, emergency medical personnel, nurses and others, who may need to save your loved one’s life if his heart should stop beating or he stops breathing.
  2. Living Will — a document that spells out what medical treatment is desired – and, maybe more importantly, not desired – by your senior loved one.
  3. Healthcare Proxy — gives a specific, stated caregiver the power to make decisions for the senior in the case of emergency when the senior is unable to speak for him or herself.
  4. Durable Power of Attorney — typically allows a designated caregiver to make both healthcare and financial decisions for a senior loved one.

We will explain each of these further in Part 2 of this post, coming next week.

Advance directives typically can be completed with witnesses, with or without an attorney.  You will want to check with the laws in the state where your senior lives to be sure you have met all laws and regulations of that state as they do vary.  You don’t want to go through everything only to learn your loved one’s wishes haven’t been properly documented and thus are not legally binding on healthcare providers.

There is another document that you and your senior loved one can complete that highlights numerous instructions, entitled “Five Wishes”.  You can hear more about that on our podcast Seniors’ Five Wishes.  These advance directives are not the same as a will that details how your senior would like his possessions dispersed in the case of death and caregivers should not assume because a senior has a will that these healthcare directives have been executed.

Individual “Right” Answers

There is no one right or wrong answer or decision about how your senior loved one wants his medical treatment to occur during an emergency or end of life situation.  It is something that most everyone faces eventually and will be the hardest decision of your life if there are no advance directives written and guidelines to follow so you clearly know and can enforce the wishes of your loved one.  Therefore, it is best if you begin the dialogue with your senior loved one and talk over what they would like to happen.

Get it in writing and keep all advance directives in a place where all caregivers and family members have access in an emergency.  Keeping it handy or even carrying it in your wallet will be helpful if needed quickly.  Give a copy to the primary doctor so he or she will be ready as needed and bring a copy when you have a scheduled hospital procedure.  Always have a copy ready to give to EMS or hospital staff if an emergency occurs.

One thing is sure, when you are in a situation covered by one of the advance directives you want to already know the wishes of your loved one!

Seniors’ Five Wishes: Key Health and End of Life Decisions

Welcome to the inaugural episode of the Senior Care Corner® Podcast!

We are introducing the podcast in hopes this medium helps reach more family caregivers.

The format of each episode will include news items for family members and other caregivers, in depth discussion of a featured topic and a tip for enhancing the life of that senior in your life.

The feature segment in this episode is a discussion of seniors’ Five Wishes, which is a process of making and documenting key decisions on health care and end of life issues to help keep a difficult time from being even more difficult for seniors and their families.

As we have said before (see the blog post link below) and will say many more times, while these are difficult conversations and sometimes harder decisions it is much better to make them in advance of being needed.

Resources Discussed in this Episode

Podcast Transcript  (so you can follow along or read at your convenience)